AC 439 (3) Library FR138 Friern Barnet Arban District Council ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH FOR THE YEAR 1960 WM. CLUNIE HARVEY, m.d., d.p.h. Medical Officer of Health FRIERN BARNET URBAN DISTRICT COUNCIL. ANNUAL REPORT of the MEDICAL OFFICER OF HEALTH for the year 1960. M. CLUNIE HARVEY, M.D., D.P.H. Medical Officer of Health. Public Health Department, Toxvn Hall, Friern Barnet, Middlesex. Mr. Chairman, Ladies and Gentlemen, I beg to present my Annual Report for 1960. The year under review has been once again uneventful. I hasten to add that this does not mean either that nothing has happened or that nothing has been done. The amenities of Friern Barnet, which were built up by the careful, loving care of past Councils, must be jealously guarded. Every year the District grov?s older, houses reach their anticipated life or even over-run that period. Although the population of Friern Barnet has not increased over the past years, we find more and more houses being occupied by multiple families; while almost every inch of available space has now been built upon. What is happening in Friern Barnet to-day, and what has been happening virtually since the end of the war, requires constant vigilance. The very fact that I can say in my Annual Report that nothing sensational has happened during 1960 is in itself a most satisfactory statement; provided, of course, as I have already suggested, that the work of preserving Friern Barnet at the level which it has already attained, is being carried out. And that, I feel I can truthfully say, has been done and is still being done to the best of our ability. The vital statistics for 1960 are eminently satisfactory, although it must again be emphasised that one year's statistics for an area with a population of just under 30,000 can only be regarded as important for comparative purposes. The death rate was 9.5, as compared with 10.5 for 1959. The birth rate rose from 13.4 in 1959 to 13.$ in I960. In other words, the rise was very slight. The infant mortality rate, i.e. the number of infants who died during -1- the first year of life per thousand live births, was 14.1, as against 39.5 in 1959. This is an astonishing drop. Once again, however, I would emphasize that, when one is dealing with such small totals, it would be extremely unwise to draw any significant conclusions. It is at least satisfactory to note that no illegitimate deaths took place during the year. Eleven point three per thousand of the infant deaths took place in children under four weeks of age; 8.5 per thousand occurred in children under the age of one week. It is also satisfactory to be able to report that only four stillbirths occurred during the year, as against seven in 1959. No maternal deaths occurred during the year. The year was also placid in relation to infectious diseases. The total number of cases notified during the year fell from 305 in 1959 to 120 in 1960. As I have commented before, however, epidemiology is no longer concerned merely with infectious diseases, but embraces a variety of conditions prejudicial to health, or to put this in another way, conditions which are capable of causing impaired health or actual disease. Thus, it is our duty to make a careful search for any conditions, hidden or disclosed, which are detrimental to the health and well-being of the community. I need scarcely emphasize that it is much more easy to prevent the setting up of such conditions than to remove them once they have been established. For this reason I have always pursued a policy of bringing before the Public Health Committee all matters affecting the health of the District, whether these matters concern environmental or personal hygiene. In this connection I count myself extremely fortunate that the Public Health Committee has always studied my statements and returns with the care which one has come to expect from the Friern Barnet Urban District Council. It is, I feel, true to say that, unless the Public Health Committee can be supplied with the fullest information, the Medical Officer of Health cannot expect that constant support without -2- which success can never be attained. The work of slum clearance, if that is the correct term to use - and I very greatly doubt that it is - still continues. Side by side, the problem of houses in multiple occupation is constantly under review, although this fortunately does not present a serious problem in Friern Barnet. I need scarcely say that housing itself plays a vital part in any programme of public health. This applies to all sections of the community, more especially to young married couples and the aged. For this reason, the building projects which have taken place or are being contemplated in Friern Barnet, are particularly pleasing. The work of smoke control is proceeding according to plan. It will be many years yet before the whole of the Urban District can be made a smoke controlled area, but we are working steadily towards this aim. Food hygiene, as always, received considerable attention during the year. This will be evidenced by the number of infringements which have been brought to the notice of the Public Health Committee. The work of ensuring the cleanliness of our food supplies must not, however, be judged solely on the number of infringements brought to the notice of the Public Health Committee, or by the number of court actions taken. The very fact that the Public Health Inspectors constantly visit food premises ensures a very necessary measure of control. This is not to say that food manufacturers or food retailers in Friern Barnet are especially prone to infringe the law or to indulge in wrong practices. None the less, whether we like it or not, we know that food handlers are sometimes apt to be careless, and that regular visits from competent, tactful Public Health Inspectors can do a great deal, if only by way of advice, to raise the standard of food handling. This practice has so far been successful in Friern B-.rnet, and will be continued. -3- The significance of health education in the vast field of public health is now an established fact. The public, generally speaking, is still to a great extent oblivious of the work being carried out in the sphere of public health on its behalf. That is why health education has such a vital part to play. The fruits of this work are shown by the very large numbers of the public who have taken advantage of poliomyelitis vaccination. Every method of bringing to the public factors of topical interest must be pursued; and every endeavour, by all means available, must be made to stress the fundamental principles upon which the healthy individual and community are based. Health education is as far as possible projected at those age groups and sections of the community which are most in need of it, without making the cardinal mistake of always speaking to the converted, and so neglecting those groups which are most difficult to reach. Our programme of health education in Friern Barnet is, I venture to say, reasonably comprehensive. Once again, I am very happy to state that the relations between the Public Health Depart-' ment and the people of Friern Barnet have remained extremely pleasant. I think it can truthfully be said that the Friern Barnet residents now appreciate that the Public Health Department is here to help them, that our sole aim is to ensure conditions within the Urban District which will favour sound health and well-being. By the same token, the relations of the Public Health Department with general practitioners have remained on a very high level. This is equally important, since we must depend upon the general practitioner, with his intimate relations with families and individuals. I cannot speak too highly of the co-operation which I have received from the general practitioners of Friern Barnet, and would take this opportunity of expressing to them my very grateful thanks. I must also mention the co-operation which exists between the Public Health Department and the Middlesex County Council. Our work must of necessity be closely inter-related. It must also be harmonious if maximum results are to be achieved. -4- This inter-relationship and harmony has been a feature of preventive medicine in Friern Barnet since 1948, and has undoubtedly produced most beneficial results. In conclusion, I would express my sincerest thanks to the Public Health Committee and to the Friern Barnet Urban District Council for the continued courtesy and assistance which I have come to expect as Medical Officer of Health. I would also express my grateful thanks to every member of the Public Health Department, in particular to my Deputy, Dr. Janet Campbell, and to Mr. Jackaman, Chief Public Health Inspector. Any Medical Officer of Health is fortunate when he knows that he has a loyal, conscientious and efficient staff. That, I am extremely glad to say, has always been my own position. I am, Mr. Chairman, Ladies and Gentlemen, Your obedient Servant, W. C. Harvey. Medical Officer of Health. -5- PUBLIC HEALTH COMMITTEE. at 31st. December, I960. Cr. J. Foley, F.F.S.,F.V.I. Cr. Mrs. W.D.M. Mackrill. (Chairman) Cr. E. Fergusson Taylor, J.P.,F.V.I. (Vice-Chairman) (Chairman of Cr. S. P. Esom, M.I. M.I. the Council) (Vice-Chairman of the Council) Cr. G. H. Flesher, F.I.O.B. Cr. Mrs. M. E. Haverly. Cr. W. H. Martin, J.P. Cr. R. F. Pugh, J.P. Cr. Miss M. J. Richards, J.P.,B.A. Cr. W. H. Tangye, J.P.,F.R.I.C.3.,F.A.I. M.D.,Ch.B.,D.P.H. Deputy Medical Officer of Health Janet R. Campbell, M.D.,Ch.B., D.P.H. PUBLIC HE'.LTH STAFF. Medical Officer of Health W. Clunie Harvey, Chief Public Health Inspector Public Health Inspector Public Health Inspector Chief Clerk W. R. Jackaman. R.N. Hedges, D.M.A. V.C. Quin (Appointed 1.2. J. Wilson. Assistant Miss E. M. Glasscock. Rodent Operative E. T. Crawshaw -6- statistics of the area. Area (in acres) 1,340 Population (Registrar General's estimate 1960). 28,670 (District - 26,430) (Friern Hospital - 2,240) Number of inhabitated houses 8,250 Rateable Value (31st. December, 1960)£454,73$ Sum represented by a penny rate £1,855 EXTRACTS FROM VITAL STATISTICS. LIVE BIRTHS. Male. Female. Total. (Legitimate) 175 l6l 336 (Illegitimate) 11 7 18 Total 186 168 354 BIRTH RATE (live births per 1000 population) 13.8 STILL births Mple. Female. Total. (Legitimate) 13 4 (Illegitimate) - Total 13 4 STILL BIRTH RATE (per 1000 total (live and still)' births) 11.2 total births 358 -7- INFANT DEATHS (under 1 year of age.) Male. Female. Total. (Legitimate) 2 3 5 (Illegitimate) - Total. 2 3 5 INFANT DEATH RATE (per 1000 live births) 14.1 INFANT DEATH RATE (per 1000 legitimate births) 14.9 INFANT DEATH RATE (per 1000 illegitimate births) 0.0 NEO-NATAL DEATH RATE (under 4 weeks per 1000 live births) 11.3 NEO-NATAL DEATH RATE (under 1 week per 1000 live births) 8.5 PERINATAL DEATH RATE (stillbirths and deaths under 1 week per 1000 total live and still births) 19.6 PERCENTAGE OF ILLEGITIMATE LIVE BIRTHS OF TOTAL BIRTHS 5.0% MATERNAL DEATHS (excluding abortion) 0.0 MATERNAL DEATH RATE (including abortion per 1000 births live and still) 0.0 DEATHS. Male. Female. Total. District 143 100 243 Friern Hospital 48 82 130 Total 191 182 373 DETH RaTE (per 1000 population including Friern Hospital) 13.0 ( " " " District only) 9.2 -8- BIRTHS. The number of births assigned to the district was 354, giving a Birth-Rate of 12.3 per 1000 of the population. The correcting factor for age and sex distribution so far as Friern Barnet is concerned is 1.12, so that the rate for comparative purposes was 13.3. 'The corresponding BirthRate for England and Wales was 17.1. Birth and Birth-Rates for the past five years have been: Birth-Rates. No. of Year. Births. Friern Barnet. England. ?c Wales. 1956 332 12.2 15.6 1957 313 12.5 16.1 1953 328 12.9 16.4 1959 344 13.4 16.5 1960 354 13.3 17.1 DE/'THS. There were 373 deaths during the year. Of these, 130 occurred in Friern Hospital and 243 in the district. This provides an un-corrected DeathRate of 13.0 per 1000 for the total population, and 9.2 per 1000 for the district excluding Friern Hospital. The correcting factor for age and sex distribution is 0.73, providing a Death-Rate for comparative purposes of 9.5. The corresponding rate for England and Wales was 11.5. The Deaths and Death-Rates for the past five years have been: -9- Death-Rates. No. of Year. Deaths. Friern Barnet. England & Wales. 1956 505 9.7 11.7 1957 483 9.6 11.5 1958 404 9.0 11.7 1959 425 10.5 11.6 1960 373 9.5 11.5 MORTALITY. General Mortality. Once again, diseases of the heart and circulation made up the greatest single cause of death in the District. Deaths from cancer made up the second largest cause, the most alarming feature being, of course, the continued increase in cancer of the lung and bronchus. This bears out what I have already said, that modern epidemiology must take into account all the factors which affect health or which produce death. These matters are, I need scarcely say, of national rather than local importance. So far as can be ascertained, there are no conditions existing in Friern Barnet which especially encourage either coronary thrombosis or lung cancer, at least in comparisicn with other parts of the country. Health education must still remain our most powerful weapon in the fight against these two very serious diseases. I myself have written on coronary thrombosis on a number of occasions, while the County Health Education Officer is paying particular attention to schools in an attempt to persuade children to resist the temptation to start smoking. This would seem to be the most profitable line of approach, and it is sincerely to be hoped that efforts made in this direction will have their effect on future generations . -10- Infant Mortality. There were 5 deaths of infants under 1 year of age, which gives an infant death rate of 14.1 per 1000 live births, as compared with 15 deaths and a rate of 43.6 in the preceeding year. Every infant death is carefully scrutinised, Although the infant mortality figures for the last few years are very much better than was the case not so many years ago, it is obvious that we must continue our struggle to eliminate all cases of infant death, whether the deaths occur in the first week, in the first month or in the first year. Stillbirths. 4 stillbirths, all legitimate were accredited to the District for 1960. This is equal to a death rate of 11.2 (live and still births), the corresponding figures for 1959 being 7 stillbirths with a rate of 19.9. Maternal Mortality. As mentioned in the introduction to this Report, no maternal death was reported during 1960. GENERAL PROVISION OF HEALTH SERVICES. Hospitals, I can add little to the remarks which I have made in the last few Annual Reports relating to the hospital services available to Friern Barnet, particularly the comments which I made in the Annual Report for 1959. The situation has altered very little, and it is still particularly difficult to obtain admission to hospital of aged persons who are not acutely ill. I invariably try to assist any general practitioner who asks for my help, and am happy to say that the support which I have been able to give general practitioners has, in many instances, proved successful. -11- Care of the Aged. As I have said on many occasions before care of the aged is assuming increasing significance year by year. The Public Health Department is, as always, prepared to help in every possible way, while our Health Visitors, Home Nurses and Home Helps continue to assist the aged by every means within their power. As the Council may be aware, I am hoping, as Area Medical Officer, to introduce two clinics for old persons in the Area. Up to the present, however, the project has had to be held up as I am extremely anxious to ensure the full co-operation of all general practitioners before any further steps are taken. I have done my best to make it clear that this Old People's Clinic will be much more social than medical. Although simple medical examinations may be undertaken by the Medical Officer in charge, i.e. urine testing, sight testing, blood pressure examination, etc., no attempt will be made to carry out any more elaborate examinations. On the other hand, we will try to help the old people by suggestions as to future employment, hobbies, diet and the like. In short, our aim will be to try to keep old people healthy, and to obviate the need for a visit to their general practitioner. As will be seen from what I have just said, we should not in any way encroach on general practitioner's preserves, but should actually help them in their work. I have every hope that the problems which exist at present will be resolved within the near future, and am quite sure that we will have the goodwill of all the general practitioners within the Urban District. I thought it wise to commence with two clinics only, although I have every intention of expanding this service and of opening a third clinic in Friern Barnet, ' if the project proves successful, as we all hope it will. I therefore mean to report further on this matter to the Public Health Committee from time to time. -12- Laboratory Facilities. As in past years, the Central Public Health Laboratory Service has been of the greatest assistance to us, not only the Central Laboratory at Colindale, but also the Laboratory at Coppetts Wood Hospital. I gratefully acknowledge the assistance afforded throughout the year, and the close co-operation which has continued for so many years between the Public Health Department and the Laboratory Service. Summary of the work carried out at the Public Health Laboratories for the year: Throat and nose swabs 2 Faeces 155 Sputum 2 Ice cream 26 Milk 96 Sausages 1 National Assistance Act 1948. Section 50. Burial or cremation of the dead. No action was necessary under this section during I960. PREVALENCE AND COTROL OF INFECTIOUS DISESES. From the table of infectious diseases set out on page 32 it will be seen that 120 cases of infectious diseases were notified during the year as against 305 in 1959. The Infectious Sickness Rate for the year was therefore 4.18 as compared with 10.64 for the previous year. The decrease in the number of infectious diseases during the year was due almost entirely to the fact that I960 was not a "measles year". The following table sets out the infectious diseases notified during 1960, as compared with the notifications received during 1959: -13-  1959. 1960.[/$$$] Measles 241 18 Pertussis (Whooping Cough) mm mm 31 Scarlet Fever 17 8 Pneumonia 18 10 Dysentery 14 39 Food Poisoning 4 1 Tuberculosis 8 11 Erysipelas 3 1 OphthalmiaNeonatorum - 1 Total 305 120 From this table the following facts emerge:- Measles notifications dropped from 241 in 1959 to 18 in I960. This was to be expected, of course, as I960 was not a "me isles year". Scarlet Fever notific tions also dropped from 70 in 1959 to 18 in I960. The type of scarlet fever met with was extremely mild, a fact to which I have made reference in several previous Annual Reports. No cases of diphtheria occurred in Friern Barnet during the year. The last death took place approximately thirteen years ago. The fact that small outbreaks of diphtheria are still occurring throughout the country, however, means that we must not relax our precautions in any way. This particularly applies to immunisation, which is now normally carried out by the triple method, i.e. diphtheria, pertussis and tetanus combined. The addition of tetanus vaccination is a welcome addition to our armamentarium. Thirty-one cases of pertussis were notified during 1960, as against nil in 1959. This was in some ways surprising, since the incidence of measles and pertussis usually run together. It must be remembered that vaccination against pertussis does -14- not guarantee complete protection against the disease. What we hope, and what indeed we have found, is that, when a vaccinated child develops pertussis, the illness is usually mild. The incidence of food poisoning and dysentery rose during the year, from a combined total of 18 during 1959 to a total of 40 during 1960. Sonne dysentery is now endemic in this country, and control measures must be rigidly applied. These measures include an adequate provision of hot water, soap and towels in schools - this is a matter we are constantly taking up - the teaching of all children to wash their hands after using the toilet and before eating food, the supply of disinfectants to schools when the incidence either of food poisoning or dysentery increases, and the use of letters excluding children who have recently suffered or are suffering from diarrhoea from school for one week, when more than a few cases have been reported from that particular school. These precautions are very necessary because, although neither food poisoning nor some dysentery can be said to be a particularly dangerous illness in school children, we know only too well that such diseases as poliomyelitis may be spread in precisely the same way. No cases of poliomyelitis were notified during 1960. Our immunisation campaign against poliomyelitis has continued without abatement. Our present figures show that more than 90% of Friern Barnet children have been protected against poliomyelitis by vaccination, a figure of which we are particularly proud. Eleven cases of tuberculosis were notified during 1960, as against 8 in 1959. Nine of these were from Friern Hospital. The Mass X-Ray Unit did not visit Friern Barnet in 1960, but it is hoped that a visit will be shortly arranged. Our scheme for the B.C.G. vaccination of school children continues and is working extremely well. This work is undertaken by the School Health Service. -15- As I have already stated, the infectious diseases picture in Friern Barnet for 1960 makes very pleasant reading. Undoubtedly, the amenities and excellent planning which are a feature of Friern Barnet must be held to have had a considerable affect on this excellent result. The fact that more than 90% of our children have been vaccinated or immunised, either against poliomyelitis or by the triple antigen (diphtheria, pertussis and tetanus) must also have had its effect. This, as I have pointed out on numerous occasions, is an excellent example of the value of co-operation between the Urban District of Friern Barnet, (the local authority) and the Middlesex County Council, (the local health authority). The Middlesex County Council is responsible for vaccination and immunisation, as an integral part of the personal health services. On the other hand, the Urban District has made a particularly valuable contribution by helping the County Council to display posters, distribute literature, etc. As the Council will be aware, the articles which I contribute to the local press are written as Medical Officer of Health, since I have always felt that my approach as Medical Officer of Health should be much more potent than any approach I can make as Area Medical Officer. In addition - and here I believe we are in many ways unique - a letter is addressed to every parent at least once each year, on the value of immunisation and vaccination, so that no parent can remain unaware of the advantages which vaccination and immunisation confer upon their children. We consider this personal approach particularly valuable, and are of opinion that, very largely by this means, we can claim the results achieved. -16- SANIT \RY SERVICES. Summary of inspections of District. Visits in connection with complaints 472 Visits in connection with infectious disease 262 Visits to shops and other places where food is prepared, stored or sold 384 Visits to other shops 180 Visits to factories 126 Visits to petrol installations 160 Visits in connection with housing and the repair of dwelling houses 1857 Visits in connection with the Rent Act 46 Visits in connection with the Clean Air Act 355 Appointments and special visits 384 Visits re infestations and disinfestations 204 Visits in connection with rodent control 1717 Miscellaneous visits 442 Total 6,589 Summary of complaints investigated. Housing defects 87 Defective drainage 12 Offensive accumulations or smells 27 Insect pests 115 Rat or mouse infestations 212 Unsound food 4 Noise nuisances Other complaints 10 Total 472 -17- HOUSING. At the beginning of the year there were sixteen houses, previously found to be unfit for habitation, subject to Orders under the Housing Act 1957, and fifteen of these had ceased to be occupied. 1-6 Carlisle Place and 29 Oakleigh Road South. N.11. These seven dwellings were included in a Clearance Area. The occupants were rehoused and the buildings demolished. 1434,1436,1438 and 1440 High Road. N.20. These four houses were in a terrace and subject to individual Demolition Orders. Because of difficulties in connection with the re-housing of one occupier the demolition of these properties was delayed but all have now been pulled down. 3. Alma Road. N.10. Subject to a Demolition Order which was extended to enable the owner to submit proposals in connection with the property. 17. Alma Road, N.10. Subject to a Demolition Order and now pulled down. 83, 126 and 134. Cromwell Road, N.10. These three dwellings had been closed on account of their condition. During the course of the year the Closing Order in respect of 134, Cromwell Road was determined, the house having been made fit for habitation, and repair works were in progress at 126, Cromwell Road. A report was submitted to the Council on the condition of 74, 75 and 76, The Avenue, N.ll., and a consequence was that the occupiers were -18- rehoused. Because of the comprehensive proposals for the clearance and redevelopment of this part of the district much of the time and effort devoted to housing matters was directed to this area, in surveys of properties and the gathering of information as a necessary preliminary to a start being made on the first phase of the programme. An effect was to limit routine investigation of housing conditions in other parts of the district, but repairs were obtained at 179 dwellings where defects were found. Inspections of dwellings during the year. 1. Number of dwelling houses inspected for housing defects (under public Health or Housing Acts) 199 2. Number of dwelling houses which were inspected and recorded under the Housing (Consolidated) Regulations 1925 and 1932) 158 3. Number of dwelling houses found to be in a state so dangerous or injurious to health as to be unfit for habitation 3 4. Number of dwelling houses (exclusive of those referred to in 3 above) found not to be reasonably suitable for occupation 128 Remedy of defects during the year without the service of formal notices. Number of defective dwelling houses rendered fit as a consequence of formal action 168 -19- Action under statutory powers during the year. (1) Proceedings under sections 9,10 and 16 of the Housing Act 1957. (a) Number of dwelling houses in respect of which notices were served requiring repairs None (2) Proceedings under Public Health Act 1936. (a) Number of dwelling houses in respect of which notices were served requiring defects to be remedied 16 (b) Number of dwelling houses in which defects were remedied after service of formal notices:- (1) By owners 11 (11) By Council in default of owners None (3) Proceedings under section 17 of the Housing Act 1957. (a) Number of dwelling houses in respect of which Demolition Orders were made None (b) Number of dwelling houses demolished 1 (c) Number of dwelling houses in respect of which Closing Orders were made 3 (d) Number of dwelling houses closed 3 (e) Number of dwelling houses in respect of which Closing Orders were determined, the dwelling having been rendered fit 1 -20- (4) Proceedings under sections 42 and 43 of the Housing Act 1957. (a) Number of Clearance Areas declared None (b) Number of unfit dwellings included in Clearance Areas None (c) Number of unfit dwellings in Clearance Areas demolished 7 Certificates of disrepair. There were six applications for certificates of disrepair under the provisions of the Rent Act 1957 and these were dealt with as follows:- (1) Applications received 6 (2) Applications withdrawn 1 (3) Landlords notified of the Council's intention to issue a certificate of disrepair:- (a) in respect of all defects 4 (b) in respect of some defects 1 (4) Undertakings by landlords to remedy defects accepted 4 (5) Certificates of disrepair issued 1 The certificate of disrepair was subsequently cancelled when the defects of repair had been remedied. Improvement Grants. Enquiries regarding the schemes of grant aid which are available to assist in providing facilities such as a bathroom, hot water supply etc., in dwellings which still lack these amenities, numbered thirty-five. after investigation of the proposals ten applications for grant aid were received and all were approved. By the end of the year the improvements had been completed in seven instances. -21- INSPECTION AND SUPERVISION OF FOOD. Food premises. There are 147 premises in the district in which food is either stored, prepared for sale, or sold. These premises are used in the following trades:- Type. Number. Registered under Food and Drugs Act 1955. For sale of ice cream. For manufacture of sausages or' preserved food. Bakers 9 1 - Butchers 13 - 9 Cafes and Restaurants 21 9 - Confectioners 30 30 - Fishmongers 6 1 - Greengrocers 22 3 — Grocers 42 28 11 Milkshops 4 4 - Total 147 76 20 There are also eleven hawkers registered in accordance with the requirements of the Middlesex County Council Act who are engaged in the following trades:- Fishmongers 2 Greengrocers 8 Grocers 1 The marketing of food is subject to regulations and byelaws made under the Food and Drugs Act. These deal with such matters as the construction, repair and maintenance of the premises, the cleanliness of apparatus and equipment, and hygiene in the handling of the food. 354 visits were made to premises to see that the requirements of the regulations -22- and byelaws were being satisfied and generally in connection with matters of food and hygiene. From this work the following improvements resulted:- Structurally improved 2 premises Cleanliness improved 8 " Floors provided or repaired 4 " Sinks provided 4 " Washbasins provided 2 " Hot water provided 10 " Lighting improved 2 " Ventilation improved 2 " Sanitary accommodation improved 6 " Lockers for clothing provided 2 " First-aid equipment provided 4 " Equipment improved 8 " Food inspection. There are no licensed slaughterhouses in Friern Barnet and consequently no post-mortem inspection of food animals. In common with other local authorities the Council was required during the year to consider and, after consultation with the interests concerned, report to the Minister of Agriculture, Fisheries and Food as to the existing and future requirements of the district in the way of slaughtering facilities. This report, to the effect that there is no local demand for slaughtering facilities, was accepted by the Minister. Of the food examined at shops and stores the undermentioned was certified to be unfit for human consumption:- Beef 273 lbs. Lamb 88 lbs. Veal 45 lbs. Liver 8 lbs. Fish 126 lbs. Chickens 110 lbs. Rabbits 35 lbs. Biscuits 2 lbs. -23- Tinned meat 42 tins. Tinned fish 1 tin. Tinned vegetables 71 tins. Tinned fruit 130 tins. This unsound food was disposed of either by incineration or by burial at the Sewage Works. Milk. Twenty persons or companies are registered for the purpose of distributing milk in the district. There is one dairy in which milk is pasteurised and bottled. All the milk sold in Friern Burnet is either pasteurised, sterilised or tuberculin-tested. The following licences were granted by the Council:- Dealer's Supplementary Licence. Licence. To sell pasteurised milk 4 9 To sell sterilised milk 19 11 To sell tuberculin-tested milk 5 10 Ninety-six samples of the different grades of milk were examined and all were satisfactory. Samples of the washed bottles from the dairy were also examined and found to be of a satisfactory standard of cleanliness. Ice cream. Seventy-six premises are registered for the sale of ice cream. Twenty-six samples of the various products offered for sale were examined bacteriologically and all were found to be satisfactory. -24- CLEAN AIR. The first smoke control area to be established in Friern Barnet came into being on the 1st. September 1960. In the early stages a few contraventions were observed and investigations shewed that the smoke resulted either from the burning of remaining stocks of bituminous coal or as a result of the lighting of fires with paper and wood. This first area covers 44 acres and contains 250 dwellings and a school. In following the programme to establish smoke control areas throughout the District a start was made on the survey of a second area (bounded by Friern Barnet Lane, Myddleton Park, Pollard Road, Manor Drive and the boundary with East Barnet). It became clear early on during the survey that because of other demands on the Department the programme could not be pursued with any continuity of action by the existing staff, and the Council agreed to the appointment of an assistant to work primarily in this field. This has accelerated progress very considerably. Measurements of smoke and sulphur gases in the atmosphere continued throughout the year and the results, which are shewn in the accompanying graphs, were sent to the Warren Springs Laboratory of the Department of Scientific and Industrial Research for use in connection with the national survey of atmospheric pollution. Generally, the figures are high, which might be expected in a built up area such as Friern Barnet. As smoke control is extended, however, there should be a progressive and substantial reduction in the level of pollution. -25- -26- FACTORIES AND SHOPS. Factories. There are 76 factories in the district most of which are of the small and light industrial type. The larger premises include an Electricity Board depot, a London Transport garage, a bag-making factory, a scientific instrument works and a drycleaning works. Inspection of factories. Number of Premises. No. on Inspec- Written Occupiers Register, tions. Notices. Prosecuted. (1) Factories without 16 23 - mechanical power. (2) Factories with mechantical 60 103 3 - power, (3) Other premises i.e. building or engineering works. - - - Total 76 126 3 - Defects found in factories. No.of cases in which defects were found. Particulars. Found. Remedied. Prosecutions. Want of cleanliness. 1 1 - Sanitary conveniences unsuitable or defective 3 3 - Other offences against the Act. 1 1 - Total. 5 5 - -27- Outwork. Occupiers of factories are required to send to the Council twice yearly lists of the persons employed by them as outworkers in certain kinds of work. This information is required to enable control to be exercised over work carried out in unsatisfactory premises or in conditions which are likely to lead to the spread of infection. Notification was received of 58 outworkers who are engaged in the following occupations:- Making wearing apparel 34 Making artificial flowers 3 Box making 18 Brush making 1 Carding buttons 1 Making lampshades 1 It was not necessary to restrict outwork in any instance during the year. Shops. There are 316 shops in Friern Barnet. The Shops Act 1950 is administered by the Council and deals with such matters as closing hours, the early closing day, Sunday trading, the employment of young persons, and the comfort and welfare of the shop assistant. One hundred and eighty visits were made to the various shops. A number of minor infringements were found and remedied, and it was not necessary to take any legal proceedings under the Act. water supply. The water supply of the district is provided by the Lee Valley Water Company, except for a small part of the South Ward which is supplied from the mains of the Metropolitan Water Board. All the houses in the district have a piped -28- internal supply. Reports on samples taken at frequent and regular intervals by the Water Companies shewed that the water was of a high standard of bacterial purity and suitable for public supply purposes. The water is not plumbo-solvent. RODENT CONTROL. Four hundred and sixty premises were inspected during the year either as a result of complaints or in the routine inspection of the district for unsuspected or unreported infestations by rats. Infestations were found at 194 premises and these were all dealt with by the Department. Treatments of the sewers were also undertaken twice during the year. The number of manholes found to be used by rats on these occasions was 24 and 17 respectively, a level of infestation very similar to that recorded last year. Eleven premises were cleared of mice. MISCELLANEOUS. Pet shops. One licence to keep a pet shop was granted under the terms of the Pet Animals Act, which includes amongst its objects the prevention of cruelty and risk of infection to pet animals which are intended for sale. The Council has applied conditions to the granting of licences which closely conform to those recommended by the Royal Society for the Prevention of Cruelty to Animals. The premises were visited regularly to see that the licence conditions were being observed. -29- Rag flock and other filling materials. The conditions under which rag flock and other filling materials arc used in upholstering etc., particularly the cleanliness of the materials, are controlled by the Rag Flock and Other Filling Materials Act. There is one trader in the district whose business is within the scope of the Act and the premises used have been registered. Heating appliances and fireguards. The Heating Appliances(Fireguards) Act makes it compulsory for all gas, electric and oil fires which are offered for sale to the public to be fitted with satisfactory guards. Visits were made to the local shops to ensure that such fires offered for sale were adequately protected. Petroleum spirit and mixtures. Twenty-five licences were granted during the year, for the storage of a total quantity of 45,540 gallons of petroleum spirit, of which 45,300 gallons were kept in underground tanks, each holding 500 gallons or more, and 230 gallons in smaller containers. Five new underground tanks, storing 10,000 gallons were installed, and the Council became the licensing authority for an installation holding 7,000 gallons which previously had been licensed by the Home Office. One hundred and sixty visits were made to the stores in connection with these new installations and generally for the safekeeping of petroleum spirit. -30- APPENDIX 1. LETTERS TO DOCTORS. Letters on the following subjects were circulated to Friern Barnet practitioners in 1960, some under my signature as Medical Officer of Health and others either as Area Medical Officer or District School Medical Officer. January 20th. - Infective Hepatitis. April 11th. - Bank Holiday Arrangements for Laboratory specimens. June 3rd. - Diarrhoea. December 16th. - Christmas Holiday Arrangements for Laboratory specimens. December 29th. - Public Health(Infectious Diseases) Amendment Regulations, 1960. APPENDIX 2. MEDICAL EXAMINATIONS. During 1960, twenty-four medical examinations were carried out in respect of new entrants to the Council's Service, Superannuation Scheme and Sickness Pay Scheme. In addition to these medical examinations, two medical reports were obtained on employees absent from duty for more than a short period, through sickness. These reports were obtained from the family doctor with whom, as I have already said, we have the most happy relations. -31- Table 1. ANALYSIS OF CASES OF NOTIFIABLE INFECTIOUS DISEASES DISEASE. NUMBER OF CASES NOTIFIED All. Un.l. 1-5 5-15 15-25 25-45 45-65 65&0 Measles IS 1 11 6 - - - - WhoopingCough 31 3 13 13 - 2 - - ScarletFever 8 - 3 5 - - - - Pneumonia 10 - 1 3 2 - 1 3 Dysentery 39 - 8 13 4 7 4 3 Tuberculosis 11 - - - 2 3 5 1 Other Tuberculosis _ _ - - - - - - Food Poisoning 1 - - — — 1 — - Erysipelas 1 - - — — — 1 - PuerperalPyrexia - - — — — — - - Ophthalmianeonatorum 1 1 - - - - - - TOTALS 120 5 36 40 8 13 11 7 -32- NOTIFIED DURING THE YEAR ENDING 31st. DECEMBER, 1960. CASES IN EACH WARD. Friern Hospital. No. Removed to Hospital. North. South. Central East. West. 6 9 2 1 — — 13 16 2 - - - 2 1 2 4 — 1 _ 2 3 4 1 - 1 1 3 21 9 8 - 1 - 2 - 2 — — - 9 — - - - - - - - _ 1 - - - - - 1 - - - - - - - - - - - - - - - - - 1 - - 45 43 15 2 5 10 9 -33- Table 2. ANALYSIS OF CASES OF TUBERCULOSIS NOTIFIED DURING 1960 AND THE MORTALITY FROM THE DISEASE OVER THE SOME PERIOD. AGES. NEW CASES. DEATHS. PULMONARY. NON-PULMONARY. PULMONARY. NON-PULMONARY M. F. M. F. M. F. M. F. 0-1 - - - - - - - - 1 - 5 - - - - - - - - 5-10 - - - - - - - - 10 - 15 - - - - - - - - 15 - 20 1 1 - - - - - - 20 - 25 - - - - - - - - 25 - 35 1 - - - - - - - 35 - 45 1 1 - - - - - - 45 - 55 2 1 - - - - - - 55 - 65 1 1 - - 1 - - - 65 & Over 1 - — 1 - - - TOTALS. 7 4 - - 2 - - - -34- Table 3. REGISTER OF TUBERCULOSIS. PULMONARY. NON-PULMONARY. TOTALS. Male. Female. Male. Female. Cases on Register at 1.1.60. 104 59 6 17 186 Cases notified for first time 1960 7 4 - - 11 Other cases added to the Register 1960 5 10 - - 15 Cases removed from Register 1960 4 5 - - 9 Cases remaining on Register 1960. 112 68 6 17 203 -35- Table 4. ANALYSIS OF THE CAUSES OF AND AGES AT DEATH CAUSE OF DEATH AT - AGES 0 to 1 1 to 2 2 to 5 5 to 15 15 to 25 25 to 45 45 to 65 65 to 75 75 and Over Accident. 1 - - - - 1 1 3 3 Bronchitis. - - - - - - 9 4 6 Cancer. - - - - - 4 32 22 13 Congenital Malformation. 2 _ - - - - - _ - Diabetes. - - - - - - 1 - - Diseases of heart and circulatory system. - - - - - 3 33 62 95 Leukaemia. - - - - - — — 1 — Misadventure. - - - - - - 1 1 - Nephritis. - - - - - - — 2 2 Other defined diseases. - 2 1 1 - 7 9 6 Other Respiratory diseases. - - - - - - - - 1 Prematurity. 2 - - - - - - - - Pneumonia - - - - - 1 7 5 15 Senility. - - - - - - - - 9 Suicide. - - - - - 2 1 - - Tuberculosis(Resp) - - - - - - 1 - 1 TOTALS. 5 2 - 1 1 11 93 109 151 -36- -37- DURING THE YEAR 1960 FOR THE WHOLE DISTRICT. WARDS. Male. Female. No. Reg. In Tran Total. Nth. Sth. Cent. East. West. Friern Hosp. - - 3 - 1 5 3 6 6 3 9 — 4 2 — 2 11 12 7 15 4 19 17 12 10 6 19 7 46 25 25 46 71 1 _ 1 _ - 1 1 1 1 2 - 1 - - - — 1 — — 1 1 34 18 28 15 30 68 91 102 115 78 193 1 - - - 1 - - 1 1 1 — — — — 1 1 1 2 — 2 1 1 - 1 1 - 2 2 2 2 4 3 3 6 1 3 10 17 9 12 14 26 - _ __ - - 1 — 1 1 _ 1 1 _ — — 1 — — 2 — 2 2 4 1 3 — 1 19 11 17 20 8 28 2 _ - — 2 5 1 8 8 1 9 2 - - - - 1 2 1 1 2 3 - - - - - 2 2 - 1 1 2 66 40 53 24 60 130 191 182 209 164 373 Table 5. INFANTILE MORTALITY. NETT DEATHS FROM STATED CAUSES AT VARIOUS AGES UNDER 1 YEAR OF AGE 1960. Under 1 week. 1-2 weeks. 2-3 weeks. 3-4 weeks. Total under 4 weeks. 4 weeks and under 3 months. 3 months and under 6 months. 6 months and under 9 months. 9 months and under 12 months. Total under 1 Year. All Causes:Certified. 3 1 - - 4 1 - - - 5 Un- Certified. — — — — - - - - - - Accident. - - - - - 1 — - — 1 Congenitalmalformation. 1 1 - - 2 - — — — 2 Prematurity. 2 - - - 2 - - - - 2 -38-